Reducing your risk of Alzheimer’s disease

By the time you reach age 85, there is a 50 percent chance you will have memory loss, mostly likely due to Alzheimer’s disease. The risk is substantially increased if the disease is present in more than one family member or if the diagnosis was made earlier than 75.

If an individual has one of the genes associated with developing Alzheimer’s disease, the risk of Alzheimer’s increases by 50 percent. If two of the genes are present, the risk increases to 100 percent.

It takes about 20 years for Alzheimer’s disease to present with symptoms of memory loss. If a parent has Alzheimer’s disease at age 70, a child who will develop Alzheimer’s disease will have abnormalities identifiable in the brain at age 50. It follows that is never too early to begin efforts to reduce their risk of this disease. Here are recommendations for at risk family members.

First, stay active and engaged in life. Research in identical twins shows that Alzheimer’s is much less common in one of the twins who stays more active into late life, does not retire, and continues to be involved in community activities.

If at high risk of developing Alzheimer’s disease, exercising the mind as often and as much as possible will prolong the onset of memory loss. Even in symptomatic patients active reading, crossword puzzles and anything that challenges the mind appears to slow the rate of progression of the disease. Adults who have a higher level of education and are lifelong learners have a lower risk of developing memory loss.

Physical exercise is a crucial component of preventing Alzheimer’s disease. It not only reduces risks of heart disease and cancer, but also decreases the chances of memory loss. Aerobic activity and strength training with weights improves strength, mood and memory.

Eating right not only reduces the risk of cardiovascular disease, but also decreases the chances of developing Alzheimer’s disease. A study just published in the Archives of Neurology examined the diet of 2,148 persons over the age of 65 and showed that the risk of Alzheimer’s was reduced by over 30 percent in those who consumed a diet that contained a higher intake of salad dressing, nuts, fish, tomatoes, poultry, cruciferous vegetables, fruits and dark and green leafy vegetables and a lower intake of high-fat dairy products, red meat, organ meat, and butter.

It is also recommended that individuals at very high risk of Alzheimer’s disease be treated as if they had had a heart attack beginning 20 years before their family member first showed symptoms of memory loss. In addition to a heart healthy lifestyle, the target bad or LDL cholesterol should be below 70.

This frequently requires the use of a medication. There is also suggestive evidence that taking an ACE inhibitor, a medication used to decrease blood pressure and reduce the risk of heart attacks and heart failure, appears to also delay the development of Alzheimer’s. (For example, if a mother developed Alzheimer’s disease at age 75, the daughter should begin therapy at age 55.)

Compulsive treatment of any medical problems will also delay the development of memory loss. It is important to aggressively treat conditions such as high blood pressure, diabetes, hypothyroidism and depression.

For someone under the age of 70, the target systolic (top) blood pressure should be consistently less than 135 and preferably less than 120. If an elevated blood sugar is identified without any other symptoms (pre-diabetes), it is important to return the level to normal by diet and medication.

While there is still much research needed to identify appropriate medical therapies that reduce risk of Alzheimer’s, some treatments that seemed promising have proven unsuccessful. For example, because Alzheimer’s is associated with inflammatory changes in the brain, researchers have suspected that drugs that reduce inflammation, such as Aleve, Motrin or Celebrex, may also reduce risks of memory loss.

Unfortunately, most evidence does not indicate a benefit and side effects are unacceptably high. In addition, researches once thought that megadoses of Vitamin E, C and A would reduce the risk of Alzheimer’s, but data shows that it may actually increase risk.

There are many strategies to decrease risk of Alzheimer’s disease — and everyone, regardless of family history, should make every effort to prevent this terrible illness.

Dr. David Lipschitz is the medical director for the Mruk Family Education Center on Aging and the Fairlamb Senior Health Clinic. Contact him at askdrdavid@gmail.com.